High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction

Ellingsen, Øyvind; Halle, Martin; Conraads, Viviane M.; Støylen, Asbjørn; Dalen, Håvard; Delagardelle, Charles; Larsen, Alf-Inge; Hole, Torstein; Mezzani, Alessandro; Craenenbroeck, Emeline M. Van; Videm, Vibeke; Beckers, Paul; Christle, Jeffrey W.; Winzer, Ephraim B; Mangner, Norman; Woitek, Felix; Höllriegel, Robert; Preßler, Axel; Monk-Hansen, Tea; Snoer, Martin; Feiereisen, Patrick; Valborgland, Torstein; Kjekshus, John; Hambrecht, Rainer; Gielen, Stephan; Karlsen, Trine; Prescott, Eva; Linke, Axel

doi:10.1161/circulationaha.116.022924

Cited by 305 publications

(340 citation statements)

References 14 publications

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“…In patients with heart failure, serious adverse events were numerically higher with HIT than with MCT. This finding and the association of myocardial infarction, need for coronary intervention, and mortality in patients with CAD with exercise session duration or intensity, even though these findings are controversial, should receive attention in future trials 17, 18, 77, 119…”

Section: Exercise Prescriptionmentioning

confidence: 95%

“…Restoration of autonomic balance in combination with improved peripheral endothelial function and decreased blood pressure reduces cardiac afterload and improves left ventricular diastolic function 42, 75, 76. Exercise training was shown to induce reverse cardiac remodeling in patients with heart failure with reduced left ventricular ejection fraction 75, 77. The impact of exercise training on intracellular calcium handling and myocardial contractility was extensively studied by Kemi and Wisloff and has been reviewed elsewhere 78.…”

Section: Adaptation Of the Heart And The Vasculature In Response To Ementioning

confidence: 99%

“…Contrary to the promising results of smaller trials, the SAINTEX‐CAD (Study on Aerobic Interval Exercise Training in CAD Patients) failed to show an additional improvement in peak oxygen uptake and endothelial function with HIT compared with MCT in patients with CAD 116. In patients with heart failure, HIT was not associated with additional reverse left ventricular remodeling or peak oxygen uptake compared with MCT in the SMARTEX‐HF (Study of Myocardial Recovery After Exercise Training in Heart Failure) trial 77. Both multicenter trials demonstrated that HIT is hardly feasible because many patients did not reach target heart rates during high‐intensity intervals despite high adherence to supervised training.…”

Section: Exercise Prescriptionmentioning

confidence: 99%

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Physical Activity in the Prevention and Treatment of Coronary Artery Disease

Winzer

Woitek

Linke

2018

JAHA

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117

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Section: Exercise Prescriptionmentioning

confidence: 95%

Section: Adaptation Of the Heart And The Vasculature In Response To Ementioning

confidence: 99%

Section: Exercise Prescriptionmentioning

confidence: 99%

See 1 more Smart Citation

Physical Activity in the Prevention and Treatment of Coronary Artery Disease

Winzer

Woitek

Linke

2018

JAHA

Self Cite

159

117

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“…Finally, an increase of prognostic CPET parameters was not significantly favoured by specific training modalities, while left ventricular remodelling revealed significant improvement after interval training vs. other modalities. In 2017, Ellingsen et al 59. published the first randomized multicentre trial evaluating high‐intensity interval training in chronic HFrEF demonstrating that 12 weeks of high‐intensity interval training was not superior to moderate continuous training with respect to left ventricular reverse remodelling or improving secondary endpoints.…”

Section: With Heart Failure Present: Exercise Improvement With Trainimentioning

confidence: 99%

Exercise and heart failure: an update

et al. 2017

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The present update is dedicated to the evolution of the interaction between heart failure (HF) and exercise and how the scientific community has handled it. Indeed, on the one hand, HF is a leading cause of morbidity and mortality with a stable prevalence from 1998 onward varying between 6.3% and 13.3%. On the other hand, exercise is seen as a diagnostic and prognostic tool as well as a therapeutic intervention in chronic HF. More precisely, the knowledge, the clinical application, and the research interest on the mutual interactions between exercise and HF have different phases in disease progression: Before HF onset (past): exercise provides protective benefit in preventing HF (primary prevention).With HF present: exercise improvement with training provides benefits in HF (secondary prevention).The prediction of future in HF patients: exercise impairment, as a leading characteristic of HF, is used as a prognostic factor.

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“…Although several training interventions have shown promising results in improving exercise capacity and QoL in HFpEF,17, 18, 19 there are no data available on the health‐relevant extent of PA for this patient cohort. Previous trials comparing different training modalities in patients with HF and risk of HF did not identify a clear intensity mode for exercise 20, 21…”

Section: Introductionmentioning

confidence: 99%

Amount or intensity? Potential targets of exercise interventions in patients with heart failure with preserved ejection fraction

et al. 2017

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AimsHeart failure with preserved ejection fraction (HFpEF) remains a common condition with no pharmacological treatment. Physical activity (PA) improves symptoms and quality of life (QoL), but no clear recommendations exist on PA in HFpEF patients. We investigated the association of PA (amount/intensity) on clinical phenotype in HFpEF.Methods and resultsThe Aldosterone in Diastolic Heart Failure trial investigated spironolactone vs. placebo in stable HFpEF patients. At baseline, all patients underwent detailed phenotypization including echocardiography, cardiopulmonary exercise testing, 6 minute walking test (6MWT), and QoL assessment (36‐item Short‐Form questionnaire). PA was assessed by a self‐report questionnaire, classified in metabolic equivalents of task (MET) and analysed with regard to exercise capacity, diastolic function, and QoL. Four hundred twenty‐two patients (52% women, age 67 ± 8 years, New York Heart Association II and III) were classified by weekly MET hours into a low (<70), middle (70–140), or high (>140) level of PA. Total PA correlated positively with 6MWT distance (r = 0.17; P = 0.002) and physical function of QoL (r = 0.10; P = 0.05), but not with peak oxygen uptake (peakVO2). In contrast, both 6MWT distance and peakVO2 were significantly higher in patients who performed high‐intensity PA for >8 h/week (P < 0.001, P = 0.02, respectively). Time of high‐intensity PA was related to higher 6MWT distance (r = 0.21, P < 0.001), peakVO2, and better physical function of QoL (both r = 0.13, P = 0.01), whereas low‐intensity PA did not show significant associations. Interestingly, PA was not related to any measure of diastolic function.ConclusionsA higher amount of PA is related to higher submaximal exercise capacity and physical function of QoL. Regarding maximal exercise capacity, only high‐intensity PA showed significant association in HFpEF patients.

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High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction

Abstract: Supplemental Digital Content is available in the text.

Cited by 305 publications

References 14 publications

Physical Activity in the Prevention and Treatment of Coronary Artery Disease

Physical Activity in the Prevention and Treatment of Coronary Artery Disease

Exercise and heart failure: an update

Amount or intensity? Potential targets of exercise interventions in patients with heart failure with preserved ejection fraction

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